Território usado e a contratualização de serviços públicos: as organizações sociais e as políticas de saúde do estado de São Paulo
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Data
2022-05-16
Autores
Costa, Nathalia Oliveira Silva
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Universidade Estadual Paulista (Unesp)
Resumo
A globalização difundiu os ideais neoliberais, que ocasionaram a reestruturação produtiva e as consequentes transformações urbanas, possibilitando às gestões públicas o estreitamento de seus vínculos com o setor privado. Na década de 1990 os ideais do New Public Management ganharam espaço entre os gestores brasileiros e foram sendo difundidos até serem colocados em prática com a Reforma do Aparelho do Estado em 1995, realizada pelo ex-Presidente da República Fernando Henrique Cardoso. A referida reforma objetivou a incorporação dos ideais corporativos e de mercado no Estado, promovendo a transferência de serviços em diversos setores. As Organizações Sociais foram as entidades privadas do terceiro setor responsáveis pela absorção dessas demandas. Na saúde, esse modelo obteve sucesso em todo o território nacional, sobretudo no estado de São Paulo, que possui legislação própria para a qualificação e contratualização das entidades desde 1998, sendo pioneiro na adoção do modelo na área da saúde. Dentre as diversas modalidades de permissão de prestação de serviços a qualificação de entidades como Organizações Sociais (OS), deteve nossa atenção por ser uma política pública recente, por estar em constante expansão tanto em metrópoles como em centros urbanos de menor porte. Além disso, compreender como os Poderes Executivo Municipal e Estadual estão se articulando para viabilizar essa parceria com as OSS parece pertinente à medida que contribui com a construção de conhecimentos acerca no novo perfil dos governos urbanos, bem como das estratégias de planejamento das cidades e de uso do território pelas entidades privadas. Portanto, delineou-se como objetivo geral identificar como as OSS colocam em uso o território brasileiro, a partir da análise particular da atuação da Rede de Saúde Santa Marcelina, especificamente recortando a atuação da Organização Social de Saúde do Hospital Geral Santa Marcelina do Itaim Paulista na Zona Leste do Município de São Paulo. Como recurso metodológico de análise do território incorporamos o conceito de situação geográfica (GEORGE, 1964; SILVEIRA, 1999; CATAIA E RIBEIRO, 2015) à pesquisa. A operacionalização do conceito se deu com a determinação de cinco variáveis-chave que ao serem analisadas de forma sistêmica fornecem um panorama das universalidades e particularidades encontradas no lugar, bem como elucida os principais atores e sua respectiva força de ação nos usos do território. A situação geográfica encontrada mostrou que a OSS analisada atua de forma hegemônica no território da Zona Leste, disputando apenas com estabelecimentos de saúde privados, bem como apresentou estratégias de atuação alinhadas com ideais corporativos de uso do território.
Globalization spread neoliberal ideals, which led to the productive restructuring and the consequent urban transformations, enabling public managers to strengthen their ties with the private sector. In the 1990s, the New Public Management ideals gained space among Brazilian managers and were disseminated with the Reform of the Brazilian State in 1995, carried out by the former President of the Republic Fernando Henrique Cardoso. This mentioned Reform aimed at the incorporation of corporative and market ideals in the State, promoting the transfer of all services in various sectors. Social Organizations were the private entities of the third sector responsible for absorbing these demands. In health sector, this model was successful throughout the national territory, especially in the State of São Paulo, which has its own laws for the qualification and contracting of entities since 1998, being a pioneer in the adoption of the model in the health area. Among the various ways of permission to provide services, the qualification of entities such as Social Organizations (OS) gained our interest because it is a recent public policy and it is constantly growth both in big cities and in smaller urban centers. In addition, understanding how the municipal and state managers are articulating itselfs into enable this partnership with the OSS seems to be relevant as it contributes to the construction of knowledge about the new profile of urban governments, as well as the strategies for planning cities and uses of the territory by private entities of third sector. Therefore, the principal aim was to identify how the OSS puts the Brazilian territory in use, especially based on the particular analysis of the performance of Santa Marcelina Health Network, highlighting the performance of the Social Health Organization of the Hospital Geral Santa Marcelina do Itaim Paulista in the East Zone at São Paulo city. As a methodological resource for analyzing the territory, we incorporated the concept of geographic situation (GEORGE, 1964; SILVEIRA, 1999; CATAIA E RIBEIRO, 2015) to this research. The operationalization of the concept took place with the determination of five key variables that, when analyzed in a systemic way provides an overview of the universalities and particularities found in the geographic space, as well as shows the main actors and their force of action in the territory uses. The geographic situation found showed that the Social Health Care Organization analized acts as hegemonic in the territory of the East Zone, competiting only with private health centers, as well as presenting action strategies aligned with corporate ideals of use of the territory.
Globalization spread neoliberal ideals, which led to the productive restructuring and the consequent urban transformations, enabling public managers to strengthen their ties with the private sector. In the 1990s, the New Public Management ideals gained space among Brazilian managers and were disseminated with the Reform of the Brazilian State in 1995, carried out by the former President of the Republic Fernando Henrique Cardoso. This mentioned Reform aimed at the incorporation of corporative and market ideals in the State, promoting the transfer of all services in various sectors. Social Organizations were the private entities of the third sector responsible for absorbing these demands. In health sector, this model was successful throughout the national territory, especially in the State of São Paulo, which has its own laws for the qualification and contracting of entities since 1998, being a pioneer in the adoption of the model in the health area. Among the various ways of permission to provide services, the qualification of entities such as Social Organizations (OS) gained our interest because it is a recent public policy and it is constantly growth both in big cities and in smaller urban centers. In addition, understanding how the municipal and state managers are articulating itselfs into enable this partnership with the OSS seems to be relevant as it contributes to the construction of knowledge about the new profile of urban governments, as well as the strategies for planning cities and uses of the territory by private entities of third sector. Therefore, the principal aim was to identify how the OSS puts the Brazilian territory in use, especially based on the particular analysis of the performance of Santa Marcelina Health Network, highlighting the performance of the Social Health Organization of the Hospital Geral Santa Marcelina do Itaim Paulista in the East Zone at São Paulo city. As a methodological resource for analyzing the territory, we incorporated the concept of geographic situation (GEORGE, 1964; SILVEIRA, 1999; CATAIA E RIBEIRO, 2015) to this research. The operationalization of the concept took place with the determination of five key variables that, when analyzed in a systemic way provides an overview of the universalities and particularities found in the geographic space, as well as shows the main actors and their force of action in the territory uses. The geographic situation found showed that the Social Health Care Organization analized acts as hegemonic in the territory of the East Zone, competiting only with private health centers, as well as presenting action strategies aligned with corporate ideals of use of the territory.
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Palavras-chave
Território usado, Contratualização, Organizações sociais de saúde, São Paulo, Used territory, Contractualization, Social health care organizations